Computer programs in gastrointestinal endoscopy: issues, problems, and solutions

For 10 years, a computerized gastrointestinal endoscopy database was promoted as necessary and desirable. At least 2 endoscopy societies, the American Society for Gastrointestinal Endoscopy (ASGE) and the World Society for Gastrointestinal Endoscopy (OMED), devoted considerable effort to develop appropriate terminology and structure. Numerous vendors and individuals developed software conforming, to various degrees, with the ASGE and OMED recommendations, and hundreds of institutions in the United States and an equal number worldwide have computerized their endoscopy paperwork. Dozens of articles and several large multicenter research efforts signal the usefulness of the database concept. Although desired, and apparently needed, endoscopy databases have not, however, caught the attention of a majority of physicians who could benefit from them--probably because of perceived difficulty with user interface. Whereas the keyboard has succeeded in virtually every other discipline, it is an enigma why there is so much anathema to this ubiquitous device among the majority of the medical community. Attempts at alternate input modalities, such as voice, resulted in several commercially available report-writers; however, the original database concept is insignificant in these current products. The international experience with this subject is reviewed with an optimistic prediction that a satisfactory doctor-computer interface will be developed, perhaps with totally new technology, and that continued interest, use, and development of an endoscopy database is justified.